Department ID: DEPT

Department ID: Account No.: Job Code number: ______

MARICOPA COUNTY COMMUNITY COLLEGE DISTRICT 2 4 1 1 W e s t 1 4 t h S t r e e t , T e m p e , A Z 8 5 2 8 1 - 6 9 4 2 SPECIAL SERVICES EMPLOYMENT

The Maricopa County Community College District (“MCCCD”) agrees to hire (“Employee”) commencing , 20XX, and ending , 20XX, to perform the following duties (“Duties”).

DESCRIBE THE ACTIVITIES TO BE PERFORMED, AND THEIR PURPOSE:

SPECIFY THE EXACT DELIVERABLES FOR THIS ASSIGNMENT AND THE WORK TIME REQUIRED PER WEEK AND IN TOTAL OVER THE SPECIFIED PERIOD OF TIME:

SPECIFY HOW THIS ASSIGNMENT IS OUTSIDE THE SCOPE OF THE EMPLOYEE’S REGULAR WORK DUTIES AND OTHER SPECIAL SERVICES EMPLOYMENTS:

IDENTIFY THE PERSON (AND TITLE) THAT THIS ASSIGNMENT WILL REPORT TO (OTHER THAN DEPT MGR):

EMPLOYEE MUST LIST ALL OTHER SPECIAL SERVICES EMPLOYMENTS IN PLACE AT THE TIME THIS CONTRACT IS PROPOSED AND FOR WHOM THE WORK WAS/IS BEING PERFORMED:

DEPARTMENT JOB DESCRIPTION DEPT MANAGER BEGIN DATE END DATE

EMPLOYEE WILL PERFORM THE DUTIES ACCORDING TO THE FOLLOWING:

Location: Course Prefix: Days of the Week: Course No.: Work Hours: Section No.: Hourly Rate: $0.00 Load Hours: Other:

MCCCD WILL COMPENSATE EMPLOYEE IN THE TOTAL AMOUNT OF $0.00.

For this assignment Employee understands that his/her employment is "at-will". This means MCCCD may terminate his/her assignment at any time during the term of this assignment with or without cause. Employee understands and accepts that this

MC-7000-HR (06/04/08) [PRINT ALL COPIES ON YELLOW PAPER] Page 1 of 2

COPIES: 1 - EMPLOYEE 2 - PERSONNEL FILE 3 - PAYROLL 4 - CAMPUS 5 – ORIGINATOR Created: 1/9/2018 assignment is not continuing in nature and nothing contained in this document shall be construed to mean assignment will continue beyond the ending date specified above. Employee understands that any instructional assignment depends upon sufficient enrollment and administrative decision in order to complete the assignment.

Any materials, products, programs, designs or other creative works developed as part of the project or services described on this Form shall be the sole property of the Maricopa Community Colleges except as provided in Paragraph 3.2.1 of the Residential Faculty Policy Manual, if applicable. Any agreement specifying that the employee shall own the works must be in writing and agreed to by an authorized representative of the Maricopa Community College before the employee performs the services specified on this Form.

Employee understands that additional assignments and/or Special Services Employment for a governing board-approved employee must be performed outside the Employee's normal work hours or hours of accountability. Employee further understands Special Services Employment may not include duties within the scope of his/her board-approved employment. In the event the additional assignments or special services employment occur during normal work hours or hours of accountability, the Employee must claim vacation or another form of absence in order to complete assignment.

MARICOPA COUNTY COMMUNITY EMPLOYEE: COLLEGE DISTRICT:

Signature: ______Signature: ______Printed Name/Title: ______Printed Name: ______Fiscal Representative: ______Employee ID No.: ______Date: ______Date: ______

Under MCCCD’s Board Policy on Special Services Employment, the following signatures are required before a current MCCCD MAT employee or residential faculty may undertake additional work under this form.**

RECOMMENDATION OF COLLEGE PRESIDENT OR VICE CHANCELLOR:

Signature: ______Printed Name: ______Date: ______

OR, if applicable, the Dean or Director delegated authority:

APPROVAL OF VICE CHANCELLOR FOR HUMAN RESOURCES:

OR, for Residential Faculty only, the President or, if applicable, the Dean delegated authority from the President:

* These signers may not be the same person. ** Authority may not be delegated below the level of Dean (colleges) or Director (District Office).

MC-7000-HR (06/04/08) [PRINT ALL COPIES ON YELLOW PAPER] Page 2 of 2

COPIES: 1 - EMPLOYEE 2 - PERSONNEL FILE 3 - PAYROLL 4 - CAMPUS 5 – ORIGINATOR Created: 1/9/2018